Arteriovenous fistula formation with adjuvant endovascular maturation

医学 动静脉瘘 瘘管 血管成形术 狭窄 外科 血液透析 血液透析通路 吻合 四分位间距 回顾性队列研究 耐火材料(行星科学) 放射科 血管通路 天体生物学 物理
作者
Shannon D. Thomas,Anders Sideris,Harry Narroway,Rohan McLachlan,Cameron Robertson,Phillip Crowe,Ramon L. Varcoe
出处
期刊:Journal of Vascular Surgery [Elsevier]
卷期号:75 (2): 641-650.e2 被引量:3
标识
DOI:10.1016/j.jvs.2021.08.072
摘要

BackgroundThe clinical utility of the native arteriovenous fistula (AVF) has been limited by the prolonged time required for maturation, the low overall maturation rate, and subsequent abandonment. Endovascular intervention has been increasingly accepted as the first-line therapy for AVF stenosis. The objective of the present study was to evaluate the AVF formation outcomes when early endovascular intervention was selectively performed to bring about timely AVF maturation.MethodsWe performed a retrospective study (February 2014 to February 2020) of 82 AVF consecutive patients (mean age, 62.5 ± 13.5 years; range, 17-83; 58 men [70.7%]) with end-stage renal failure who had undergone vascular access construction at a single institution. The 4-year AVF patency, vascular diameters, hemodialysis parameters, reintervention rate, and mortality were analyzed.ResultsRadiocephalic AVF was the most common fistula constructed (71 patients; 88.6%). The evaluation at a mean of 46.2 ± 56.0 days (range, 5-343 days) after AVF formation revealed 33 immature AVFs (40.2%). Subsequently, 19 patients had undergone endovascular procedures, including angioplasty and/or stenting of the juxta-anastomosis, cannulation zones, and/or outflow segments to bring about timely maturation of the AVF. Hence, 93.9% of the AVFs had reached functional patency (maturation) by 6 months after formation, with a mean time to maturation of 67.8 ± 65.9 days (range, 5-320 days). After reaching maturation, the primary access functional patency was 82% ± 4.3% at 6 months, 58% ± 5.5% at 12 months, and 34% ± 6.8% at 48 months. The primary assisted access functional patency was 95% ± 2.4% at 6 months, 90% ± 3.3% at 12 months, and 83% ± 4.7% at 48 months. A total of 121 endovascular interventions were performed to maintain patency, equating to an endovascular reintervention rate of 0.37 procedure/patient year. The mean arterial, venous, and brachial flow rates did not change significantly after maturation with a mean AVF (primary assisted functional patency) survival time of 5.9 ± 0.26 years (range, 5.33-6.36 years) from maturation. Only 12 thromboses had occurred after the first follow-up review after AVF formation. These were all salvaged using endovascular techniques, leading to 100% total secondary functional patency at 4 years. The 5-year estimated all-cause mortality was 45.6% ± 12.7%.ConclusionsThe AVF maturation rate and interval to maturation were improved when early endovascular intervention was selectively performed after AVF formation. This allowed for near universal maturation. In addition, once matured, the use of ongoing endovascular reinterventions allowed for a low reintervention rate and long-term patency, providing reliable long-term renal vascular access.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
大幅提高文件上传限制,最高150M (2024-4-1)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
若若完成签到,获得积分10
7秒前
8秒前
9秒前
若若发布了新的文献求助10
14秒前
G.Huang完成签到,获得积分10
26秒前
zyl完成签到,获得积分10
43秒前
谎言不会伤人完成签到,获得积分10
45秒前
大翟完成签到,获得积分10
52秒前
拼搏的向雁完成签到 ,获得积分10
1分钟前
狂野的白开水完成签到 ,获得积分10
1分钟前
建丰完成签到,获得积分10
1分钟前
1分钟前
1分钟前
ZH完成签到 ,获得积分10
1分钟前
糖宝完成签到 ,获得积分10
1分钟前
科研通AI2S应助张某某采纳,获得10
1分钟前
荔枝完成签到 ,获得积分10
1分钟前
乃惜完成签到,获得积分10
1分钟前
lwtsy完成签到,获得积分10
1分钟前
gc完成签到 ,获得积分10
1分钟前
dungaway完成签到,获得积分10
1分钟前
觅兴完成签到,获得积分0
1分钟前
丰富的绮山完成签到,获得积分10
1分钟前
hehuan0520完成签到,获得积分10
1分钟前
那一天完成签到 ,获得积分10
2分钟前
好名字完成签到 ,获得积分10
2分钟前
乐乐完成签到,获得积分10
2分钟前
wrl2023完成签到,获得积分10
2分钟前
2分钟前
阿司匹林完成签到 ,获得积分10
2分钟前
2分钟前
浅浅殇完成签到,获得积分10
2分钟前
月夜花朝完成签到 ,获得积分10
2分钟前
DJ_Tokyo完成签到,获得积分10
2分钟前
wBw完成签到,获得积分10
2分钟前
2分钟前
yahonyoyoyo完成签到,获得积分10
2分钟前
echo完成签到 ,获得积分10
2分钟前
yahonyoyoyo发布了新的文献求助10
2分钟前
松子的ee完成签到 ,获得积分10
2分钟前
高分求助中
Un calendrier babylonien des travaux, des signes et des mois: Séries iqqur îpuš 1036
Sustainable Land Management: Strategies to Cope with the Marginalisation of Agriculture 1000
Corrosion and Oxygen Control 600
Python Programming for Linguistics and Digital Humanities: Applications for Text-Focused Fields 500
Heterocyclic Stilbene and Bibenzyl Derivatives in Liverworts: Distribution, Structures, Total Synthesis and Biological Activity 500
重庆市新能源汽车产业大数据招商指南(两链两图两池两库两平台两清单两报告) 400
Division and square root. Digit-recurrence algorithms and implementations 400
热门求助领域 (近24小时)
化学 材料科学 医学 生物 有机化学 工程类 生物化学 纳米技术 物理 内科学 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 电极 光电子学 量子力学
热门帖子
关注 科研通微信公众号,转发送积分 2546170
求助须知:如何正确求助?哪些是违规求助? 2175672
关于积分的说明 5600253
捐赠科研通 1896399
什么是DOI,文献DOI怎么找? 946273
版权声明 565379
科研通“疑难数据库(出版商)”最低求助积分说明 503557